Individual
NELSON DARIO LURAGUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF RADIOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Mailing address
1512 W KIRBY PL, DEPARTMENT OF RADIOLOGY, SHREVEPORT, LA 71103-3822
(318) 675-7636
(318) 675-7531
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15649R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1464171
—
LA
01
—
4J190F600
MEDICARE - PTAN
LA
Enumeration date
07/20/2006
Last updated
07/08/2011
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